Cervical cancer is one of the most preventable and treatable cancers, yet it continues to be a major public health challenge in India. The country reports significantly higher incidence and mortality rates compared to many other nations. According to the HPV-Related Cancers Factsheet 2023, nearly 1,23,907 women in India are diagnosed with cervical cancer each year, and approximately 77,348 women die annually due to this disease. This makes cervical cancer the second most common cancer among Indian women, after breast cancer. 

The statistics are alarming, especially considering that cervical cancer is largely preventable. Despite the high disease burden, India still lacks a nationwide, government-sponsored cervical cancer screening program, which significantly limits early detection. 

The primary cause of cervical cancer is persistent infection with high-risk strains of the Human Papillomavirus (HPV). HPV is an extremely common virus transmitted through sexual contact. Research indicates that nearly 99% of cervical cancer cases are linked to HPV infection. 

The Role of HPV 

Medical evidence suggests that early detection and prevention of HPV infection can reduce cervical cancer risk by up to 90%, highlighting the critical role of screening and vaccination. 

Cervical Cancer Screening Guidelines: What Women Should Know 

Regular screening is one of the most effective ways to detect cervical cancer at an early, treatable stage. 

According to the Indian Cancer Society, Bengaluru and USPSTF guidelines: 

-          Women aged 21 to 29 years should undergo a Pap test every three years 

-          Women aged 30 to 65 years should have a Pap test combined with an HPV test once every five years 

As per the American Cancer Society guidelines, women above 65 years of age who have had regular screenings with normal results may discontinue cervical cancer screening. 

The Way Forward: Awareness, Screening, and Prevention 

 Cervical cancer does not have to be fatal. With timely screening, HPV vaccination, and awareness, most cases can be prevented or treated successfully. Expanding access to screening services and educating women about cervical cancer symptoms, risk factors, and preventive care is essential to reducing the disease burden in India. 

Dr Sudhendu Shekhar (Director- Department of Oncology) and Dr Sandeep Tiwari (Consultant, Medical Oncology), Ujala Cygnus Laxmi Hospital Varanasi has answered some important questions related to cervical cancer. Here you can read the interview: 

What is cervical cancer and what are its types? 

Cervical cancer is a type of cancer that occurs when abnormal cells grow in the lining of the cervix. Mainly, there is only one type of cervical cancer, squamous cell carcinoma. However, there are also less common types, including adenocarcinoma, adenosquamous carcinoma, and small-cell cancer.  

What are the symptoms of cervical cancer? When should you visit a doctor?  

Common symptoms of cervical cancer include bleeding between periods, bleeding after sexual intercourse, and bleeding after menopause. Other symptoms may include pelvic pain, unusual whitish vaginal discharge, or foul-smelling vaginal discharge. If any of these symptoms persist, it is important to consult a doctor for evaluation. In addition, any changes or disturbances in urination, such as difficulty, pain, or other urinary problems, warrant medical attention. Early consultation can help in timely diagnosis and treatment. 

Are cervical cancer cases increasing in India? 

 In India, many cervical cancer cases are diagnosed at a late stage, primarily due to a lack of awareness. Many women are unaware that early symptoms could indicate cervical cancer. Even when symptoms appear, they are often ignored or not recognized as warning signs. In some cases, social stigma and hesitation lead women to hide their symptoms and delay seeking medical care. As a result, many patients visit hospitals only when the condition becomes severe or unavoidable, which contributes to late diagnosis and poorer outcomes. 

What are the measures to prevent cervical cancer? 

 Cervical cancer is one of those cancers that we can largely prevent. The most common cause of cervical cancer is HPV (human papillomavirus). This is a type of infection. If we stop this infection at an early stage, then almost 90 percent of cervical cancer can be prevented. Primarily, one can avoid this virus by maintaining hygiene. We can say the more hygiene is maintained, the less the risk of infection will be. Secondly, vaccines, just like we heard that the Coronavirus was an infection. Similarly, HPV is also a virus that is transmitted through sexual routes. So, if we use vaccines against this virus, then we can largely prevent HPV infection and cancer caused by it. 

Is the vaccine effective in preventing cervical cancer? 

 Yes, very much. Vaccines are a very important weapon for us. We can prevent HPV infection and the causes of cancer if we take a vaccine against the virus. Mainly two types of vaccines are available in India right now. Bivalent and quadrivalent. Bivalent means it prevents cancer from two virus subtypes. Quadrivalent means it prevents infection from four common subtypes. Recently, vaccines made in India have also become available. The ideal time to get these vaccines is 9–26 years (9-14 years- two dose and 15-26 years- three dose). Even after that, these vaccines can be useful, but the best and ideal time is 9–14 years. As I said, this is a sexually transmitted disease, so if we use HPV vaccines in both boys and girls, then in their adult lives, those children will not be able to transmit that infection to another person. That is why these vaccines are advised not only for girls but also for boys. 

 Does cervical cancer impact fertility? 

 Cancer is affecting the lowermost part of the uterus. It can affect fertility. After treatment in the early stage, we can preserve the uterus and try to ensure that the patient has childbearing. There is a possibility of having a child. However, if there is an advanced disease, then fertility can be largely affected. 

If you have specific questions about cervical cancer, please get in touch with the nearest Ujala Cygnus Hospital or reach our health experts at askadoctor@ujalacygnus.com. 

FAQ  

Is cervical cancer treatable?  

Cervical cancer is very treatable if caught early. 

Where is the highest incidence rate of cervical cancer in India?  

Papumpare district in the state of Arunachal Pradesh had the highest incidence rate of cervical cancer (27.7) in Asia. It is noticeable that cervical cancer is a major cause of cancer mortality in women, and more than a quarter of its global burden is contributed by developing countries.  

How many women are diagnosed with cervical cancer worldwide? 

 In 2022, an estimated 6,60,000 women were diagnosed with cervical cancer worldwide, and about 3,50,000 women died from the disease. 

What are the factors that increase the risk that an HPV infection will cause cancer? 

Weak immune systems, smoking or breathing secondhand smoke, obesity, and reproductive factors are the main factors that increase the risk of HPV infection. 

Why is the HPV vaccine offered to girls and boys before the age of 12? 

The HPV vaccine offers the most protection when given before a person becomes sexually active. Those who are sexually active may benefit less from the vaccine because they may have been exposed to some of the HPV types the vaccine targets. That’s why the ideal age for HPV vaccination for girls and boys is 11-12, and the vaccine can be given starting at age 9. HPV vaccination is recommended up to age 26. Also, people between the ages of 27 and 45 who are not vaccinated can take the vaccine after doctor consultation about their risk of new HPV infections.